Which anticancer drug causes hypercoagulable syndrome?
**Core Concept**
The question is testing the ability to recognize a side effect of anticancer medications, specifically a hypercoagulable syndrome. This condition is characterized by an increased tendency for blood clots to form, which can lead to serious complications.
**Why the Correct Answer is Right**
L-asparaginase, an enzyme used in the treatment of acute lymphoblastic leukemia (ALL), can cause a hypercoagulable state. This is due to its ability to decrease the levels of antithrombin III, a protein that inhibits blood clotting. Additionally, L-asparaginase can increase the levels of plasminogen activator inhibitor-1 (PAI-1), which further contributes to the hypercoagulable state. This can lead to an increased risk of thrombosis, including deep vein thrombosis (DVT) and pulmonary embolism (PE).
**Why Each Wrong Option is Incorrect**
**Option A:** Cisplatin is a platinum-based chemotherapy drug that can cause nephrotoxicity, ototoxicity, and neurotoxicity, but it is not typically associated with a hypercoagulable syndrome.
**Option B:** 5-Fluorouracil (5-FU) is a pyrimidine analog used in the treatment of various cancers, including colorectal and breast cancer. It can cause myelosuppression, mucositis, and diarrhea, but it is not commonly associated with a hypercoagulable state.
**Option C:** Doxorubicin is an anthracycline antibiotic used in the treatment of various cancers, including breast and ovarian cancer. It can cause cardiotoxicity, myelosuppression, and alopecia, but it is not typically associated with a hypercoagulable syndrome.
**Clinical Pearl / High-Yield Fact**
L-asparaginase-induced hypercoagulable syndrome is a well-known side effect of this medication, and patients receiving L-asparaginase should be closely monitored for signs of thrombosis. This includes regular assessment of coagulation parameters, such as activated partial thromboplastin time (aPTT) and international normalized ratio (INR).
**Correct Answer:** C. L-asparaginase.